When environmental health researchers study hazards in the home, they often discover information that may be relevant to protecting the health and safety of the research subjects and occupants. This article describes the ethical and legal basis for a duty to warn research subjects and occupants about hazards in the home and explores the extent of this duty. Investigators should inform research subjects and occupants about the results of tests conducted as part of the research protocol only (...) if the information is likely to be accurate, reliable, and medically useful. Investigators should warn subjects and occupants about hazards they happen to discover while they are in the home, if a reasonable person would warn the subjects and occupants about those hazards. Investigators should not report illegal hazards discovered in the home to the authorities, unless those hazards constitute abuse or neglect of children or mentally disabled people living in the home. When investigators decide to warn research subjects and occupants about hazards in the home, they should take some steps to help them make effective use of this information, such as providing additional counselling or making a referral for remediation or medical treatment. Investigators should discuss these issues with research subjects during the informed consent process. (shrink)

This article presents the case of an HIV-positive client who reported having sexual relations with an unknowing partner. The issue raised is whether the therapist was required to warn the unknowing partner, similar to the Tarasoff mandate that is imposed on therapists. The case is analyzed from an ethical framework similar to that presented by Beauchamp and Childress (1994). Two opinions are presented, each leading to different conclusions about whether the therapist should inform the unknowing partner. It is concluded (...) that although such analysis is valuable in aiding the therapist in his or her decision-making process, no clear professional standard for the management of the problem is evident. (shrink)

Nurses who attend patients with psychiatric disorders often encounter ethical dilemmas and experience difficulties in making the right decision. The present study aimed to evaluate the decisions of psychiatric nurses regarding their duty to warn third parties about the dangerousness of the patient, the need for compulsory hospitalization, and the competence of patients. In total, 111 nurses working in the field of psychiatry in Turkey completed a questionnaire form consisting of 33 questions. The nurses generally assessed the decision-making (...) competency of the patient correctly. However, their decisions regarding whether the patient should be compulsorily hospitalized and their understanding of their duty to warn/protect were less consistent. A significant relationship was found between the decisions of the psychiatric nurses and their work experience, them having children, and them having postgraduate education in psychiatric nursing. The nurses stated their desire to be part of the team that decided on ethical problems in psychiatry. (shrink)

Amid the controversies surrounding physician-assisted suicides, euthanasia, and long-term care for the elderly, a major component in the ethics of medicine is notably absent: the rights and welfare of the survivor's family, for whom serious illness and death can be emotionally and financially devastating. In this collection of eight provocative and timely essays, John Hardwig sets forth his views on the need to replace patient-centered bioethics with family-centered bioethics. Starting with a critique of the awkward language with which philosphers (...) argue the ethics of personal relationships, Hardwig goes on to present a general statement on the necessity of family-centered bioethics. He reflects on proxy decisions, the effects of elder care on the family, the financial and lifestyle consequences of long-term care, and physician-assisted suicide from the perspective of the family. His penultimate essay, "Is There a Duty to Die?" carries the idea of family-centered ethics to its logical, controversial, conclusion; comments upon this essay from Daniel Callahan, Larry Churchill, Joanne Lynn, and journalist Nat Hentoff offer differing views on this highly charged subject. As advances in medicine prolong patient's lives, the welfare of those ultimately responsible for medical care-the family-must be addressed. Hardwig's courageous and illuminating essays set forth a new direction in bioethics: one that considers the welfare of everyone concerned. (shrink)

Making research data readily accessible during a public health emergency can have profound effects on our response capabilities. The moral milieu of this data sharing has not yet been adequately explored. This article explores the foundation and nature of a duty, if any, that researchers have to share data, specifically in the context of public health emergencies. There are three notable reasons that stand in opposition to a duty to share one’s data, relating to: (i) data property and (...) ownership, (ii) just distribution of benefits and burdens and (iii) the contemporary ethos of science. We argue each reason can be successfully met with corresponding rationale in favour of data sharing. Further support for data sharing has been echoed in policies of health agencies, funding bodies and academic institutions; in documents on the ethical conduct of biomedical research; and in discussions on the nature of public health. From this, we ascertain that sharing data is the morally sound default position. This article then highlights the key roles reciprocity and solidarity play in supporting the practice of data sharing. We conclude with recommendations to regard public health research data as a common-pool resource in order to build a framework for stable data sharing management. (shrink)

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting (...) that healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard. (shrink)

The world's aging populations face novel health challenges never experienced before in human history. The moral landscape thus needs to adapt to reflect this novel empirical reality. In this paper I take for granted one basic moral principle advanced by Peter Singer and explore the implications that empirical considerations from demography, evolutionary biology, and biogerontology have for the way we conceive of fulfilling this principle at the operational level. After bringing to the fore a number of considerations that Singer ignores, (...) such as the probability that nonintervention will result in harm and the likelihood that different kinds of extrinsic and intrinsic harms can be prevented, I argue that the aspiration to extend the human biological warranty period (by retarding the rate of aging) is a pressing moral imperative for the twenty-first century. In the final sections I briefly address some standard objections raised against life extension and conclude that, while there may be some legitimate concerns worth addressing, they are not compelling enough to provide a rational basis for forfeiting the potential health and economic benefits that could be realized by extending the biological warranty period. (shrink)

This article explores the law and ethics of lobbying. The legal discussion examines disclosure regulations, employment restrictions,bribery laws, and anti-fraud provisions as each applies to the lobbying context. The analysis demonstrates that given the social value placed on the First Amendment, federal law generally affords lobbyists wide latitude in determining who, what, when, where, and how to lobby.The article then turns to ethics. Lobbying involves deliberate attempts to effect changes in the law. An argument is advanced that because (...) law implicates the use of force and because law ideally reflects the values of a democratic society, seeking to slant the law to serve a client’s narrow interests cannot provide an adequate ethical end for a lobbyist. On the contrary, a lobbyist has an affirmative moral duty to seek reasonably balanced and just laws. The article examines, refines, and defends this proposition in a number of settings. (shrink)

In this article, Gostin and Archer explore the varied lenses through which governments are obligated to address humanitarian needs. States’responsibilities to help others derive from domestic law, political commitments, ethical values, national interests, and international law. What is needed, however, is clarity and detailed standards so that States can operationalize this responsibility, making it real for developing countries. Transnational cooperation needs to be more effective and consistent to provide assistance for the world's poorest and least healthy people.

Many philosophers have objected to Kant’s account of duties regarding non-human nature, arguing that it does not ground adequate moral concern for non-human natural entities. However, the traditional interpretation of Kant on this issue is mistaken, because it takes him to be arguing merely that humans should abstain from animal cruelty and wanton destruction of flora solely because such actions could make one more likely to violate one’s duties to human beings. Instead, I argue, Kant’s account of duties regarding nature (...) grounds much stronger limitations on how humans may treat non-human animals and flora, since such duties are rooted in the imperfect duty to increase one’s own moral perfection. This duty proscribes actions affecting non-human nature that decrease one’s moral perfection, such as those that cause organisms unnecessary harm. Moreover, the duty to moral perfection prescribes (but does not strictly require) actions affecting non-human nature that increase one’s moral perfection, such as those that benefit organisms. Given this interpretation, I show that, contrary to a widely held view, Kant’s moral philosophy can ground a coherent and robust approach to environmental ethics. (shrink)

Thanks to recent scholarship, Kant is no longer seen as the dogmatic opponent of suicide he appears at first glance. However, some interpreters have recently argued for a Kantian view of the morality of suicide with surprising, even radical, implications. More specifically, they have argued that Kantianism (a) requires that those with dementia or other rationality-eroding conditions end their lives before their condition results in their loss of identity as moral agents, and (b) requires subjecting the fully demented or those (...) confronting future dementia to non-voluntary euthanasia. Properly understood, Kant’s ethics has neither of these implications. (a) wrongly assumes that rational agents’ duty of self-preservation entails a duty of self-destruction when they become non-rational. (b) further neglects Kant’s distinction between duties to self and duties to others and wrongly assumes that duties can be owed to rational agents only during the time of their existence. (shrink)

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Clinicians and health researchers frequently encounter opportunities to rescue people. Rescue cases can generate a moral duty to aid those in peril. As such, bioethicists have leveraged a duty to rescue for a variety of purposes. Yet, despite its broad application, the duty to rescue is under-analyzed. In this paper, we assess the state of theorizing about the duty to rescue. There are large gaps in bioethicists’ understanding of the force, scope, and justification of the two (...) most cited duties to rescue—the individual duty of easy rescue and the institutional rule of rescue. We argue that the duty of easy rescue faces unresolved challenges regarding its force and scope, and the rule of rescue is indefensible. If the duty to rescue is to help solve ethical problems, these theoretical gaps must be addressed. We identify two further conceptions of the duty to rescue that have received less attention—an institutional duty of easy rescue and the professional duty to rescue. Both provide guidance in addressing force and scope concerns and, thereby, traction in answering the outstanding problems with the duty to rescue. We conclude by proposing and propose research priorities for developing accounts of duties to rescue in bioethics. (shrink)

This paper investigates the nature and foundation of duties to oneself in Kant's moral theory. Duties to oneself embody the requirement of the formula of humanity that agents respect rational nature in them-selves as well as in others. So understood, duties to oneself are not subject to the sorts of conceptual objections often raised against duties to oneself; nor do these duties support objections that Kant's moral theory is overly demanding or produces agents who are preoccupied with their own virtue. (...) Duties to oneself emerge as an essential and compelling part of Kant's moral theory. (shrink)

Recent years have heralded increasing attention to the role of multinational corporations in regard to human rights violations. The concept of complicity has been of particular interest in this regard. This article explores the conceptual differences between silent complicity in particular and other, more "conventional" forms of complicity. Despite their far-reaching normative implications, these differences are often overlooked.Rather than being connected to specific actions as is the case for other forms of complicity, the concept of silent complicity is tied to (...) the identity, or the moral stature of the accomplice. More specifically, it helps us expose multinational corporations in positions of political authority. Political authority breeds political responsibility.Thus, corporate responsibility in regard to human rights may go beyond "doing no harm" and include apositive obligation to protect. Making sense of this duty leads to a discussion of the scope and limits of legitimate human rights advocacy by corporations. (shrink)

This article is concerned with a discussion of the plausibility of the claim that GM technology has the potential to provide the hungry with sufficient food for subsistence. Following a brief outline of the potential applications of GM in this context, a history of the green revolution and its impact will be discussed in relation to the current developing world agriculture situation. Following a contemporary analysis of malnutrition, the claim that GM technology has the potential to provide the hungry with (...) sufficient nourishment will be discussed within the domain of moral philosophy to determine whether there exists a moral obligation to pursue this end if and only if the technology proves to be relatively safe and effective. By using Peter Singer’s duty of moral rescue, I argue that we have a moral duty to assist the third world through the distribution of such GM plants. I conclude the paper by demonstrating that my argument can be supported by applying a version of the Precautionary Principle on the grounds that doing nothing might be worse for the current situation. (shrink)

Researchers have frequently complained that the NHS ethical review system stifles good research. At last measures are being put in place to address this criticism, but will they undermine the protection of research participants? The Declaration of Helsinki recognizes that medicine will not progress without good quality research, but also demands that the well-being of research participants takes precedence over the interests of science and society. This article examines the implications of the ongoing reform of the NHS research ethics (...) review system for researchers, ethics committees and research participants. (shrink)

In this response to Johnson, Oh reaffirms the scholarly vision of Kelsay and Twiss, elaborates upon Muslim perspectives on human rights, and questions the emphasis on violent humanitarian interventions as part of the Responsibility to Protect mandate. Oh suggests that, in light of the historical relationship between Muslim and non-Muslim states and the aftermath of the second Iraq War, more consideration be given to the rebuilding of Muslim-majority societies. Oh also highlights the concept of duty as a religiously based (...) ideal to which governments of Muslim nations ought to be held. (shrink)

The central question in political philosophy is whether political states have the right to coerce their constituents and whether citizens have a moral duty to obey the commands of their state. Christopher Heath Wellman and A. John Simmons defend opposing answers to this question. Wellman bases his argument on samaritan obligations to perform easy rescues, arguing that each of us has a moral duty to obey the law as his or her fair share of the communal samaritan chore (...) of rescuing our compatriots from the perils of the state of nature. Simmons counters that this, and all other attempts to explain our duty to obey the law, fail. He defends a position of philosophical anarchism, the view that no existing state is legitimate and that there is no strong moral presumption in favor of obedience to, or compliance with, any existing state. (shrink)

A critical issue facing the criminal justice system today is how best to promote ethical behavior by public prosecutors. The legal profession has left much of a prosecutor’s day-to-day activity unregulated, in favor of a general, catch-all admonition to “seek justice.” In this article the author argues that professional norms are truly functional only if those working with a given ethical framework recognize the system’s implicit dependence on character. A code of professional conduct in which this dependence is not recognized (...) is both contentless and corrupting. Building on the ethics of Aristotle and modern philosophers Alasdair MacIntyre and Bernard Williams, the author argues that virtue theory can help bridge the gaps in prosecutorial ethics where other forms of moral reasoning fail. The author analyzes three especially difficult ethical problems frequently confronted by prosecutors in the field. He demonstrates not only that the Model Rules of Professional Conduct and the ABA Criminal Justice Standards fail to answer any of these complex questions, but also that future attempts to more closely regulate how prosecutors should act in any of these nuanced situations are unlikely to succeed. The author argues that honesty, fairness, courage, and prudence are the primary virtues that citizens have a right to expect of their public prosecutors. He then demonstrates how these four key virtues might provide important guidance to conscientious prosecutors striving to do what is right. The author concludes by offering several insights into how the field of virtue ethics might inform both the structure and organization of government law offices, and the manner in which individual prosecutors working within these offices might perceive and fulfill their professional roles. (shrink)

This article recommends the film Inside Job as an effective teaching tool for illustrating the ethical issues that surrounded the global financial crisis of 2008 and the subsequent economic downturn. The study discusses issues such as the revolving door, conflicts of interest, fiduciary duty, executive compensation, and financial regulation. The presentation of each ethical issue comprises suggested questions, background information, and guides to specific sections of the film. An overview of the film is provided as well.